PROJECT SUMMARY The long-term objective of this project is to improve the reach and uptake of evidence-based lifestyle programs to reduce disparities in diabetes (T2D) related outcomes among immigrant men. The study will explore the role of social networks, defined as family and peers, to support healthy lifestyle behaviors among immigrant men through the shared medical appointment model and to understand the diffusion of health behaviors amongst participants? social networks. The aims are to: (1a & 1b) Qualitatively explore perceptions and cultural preferences for a clinic-based shared medical appointment intensive lifestyle intervention to inform program adaptation; (2) Conduct a pilot study to evaluate the feasibility and acceptability of social network- based (participant + social partner) versus individual-based (participant only) SMA ILI among South Asian and West African immigrant participants with prediabetes/T2D; and (3) Assess the behavioral outcomes of the pilot intervention amongst members of participants? social networks to determine if there are spillover effects. The project will prepare Dr. Shah to transition to an independent clinician scientist using innovative health system- based models to leverage family and social networks to improve health outcomes and reduce disparities among vulnerable populations. Her career development plan includes these training goals to: (1) Gain skills in cultural adaptation of an intervention to reduce prediabetes/T2D; (2) Develop expertise in pragmatic evaluation design, protocols, and analysis; (3) Obtain advanced skills in social network analysis; and (4) Advance skills in presentation, manuscript and grant-writing. The research will be conducted in the primary care setting of the Emory Family Medicine Center in Dunwoody, GA, which serves a diverse patient population and is the site of Dr. Shah?s clinical practice. This K23 Career Development Award will also leverage the training resources of the Georgia Clinical and Translational Science Alliance. Results from this project will provide pilot data for an R01/R18 application to further evaluate the reach and uptake of culturally adapted lifestyle interventions for immigrant men with prediabetes and type 2 diabetes, an underrepresented group in current translational studies to date.